Efficacy and safety of modified combined dorsal-volar approach for internal fixation in high-energy trauma-induced comminuted distal radius fracture with concomitant scaphoid fracture

This study investigated the clinical outcomes of the modified combined dorsal-volar approach for internal fixation of comminuted distal radius fractures complicated by scaphoid fractures resulting from high-energy trauma. A cohort of 100 patients with concurrent distal radius and scaphoid fractures underwent surgical management by this approach. Postoperative assessments included wrist joint function recovery, operative parameters (surgical time, intraoperative blood loss, and hospital stay), range of motion (ROM), functional scores (Disabilities of the Arm, Shoulder, and Hand [DASH], Bartra, and Gartland-Werley), fracture healing-related indicators, and serum inflammatory cytokine levels. Univariate and multivariate analyses were performed to identify independent predictors of wrist functional recovery. The results demonstrated an 88.0% excellent-to-good rate for postoperative wrist function. The mean surgical time was 141.39±20.21 minutes, with intraoperative blood loss averaging 114.84±24.87 mL and a mean hospital stay of 12.01±4.35 days. Significant improvements were observed in ROM, functional scores, and fracture healing-related measures, alongside a marked reduction in inflammatory cytokines. Age (odds ratio [OR] =14.194), DASH score (OR=1.395), and Gartland-Werley score (OR=1.431) were identified as independent prognostic factors for wrist functional recovery. These findings underscore the effectiveness of the modified combined dorsal-volar approach in restoring wrist joint function, facilitating fracture union, and mitigating inflammatory responses in patients with these conditions.